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Several small-scale trials indicate a positive correlation between dietary creatine intake and fat-free mass in the pediatric population; whether this connection occurs at the population-wide level remains currently unknown. The main purpose of this cross-sectional study was to calculate the amount of creatine consumed through a regular diet among U.S. boys and girls aged 8 to 19 years, and investigate the link between creatine consumption and dual-energy X-ray absorptiometry (DXA)-derived body composition indices in this population. Data were obtained from the National Health and Nutrition Examination Survey 2017-2018 round, with dietary information and whole-body DXA body composition measures extracted for respondents aged 8 to 19 years (1273 participants, 649 boys and 624 girls). Individual values for total grams of creatine consumed per day for each participant were computed using the average amount of creatine (3.88 g/kg) across all creatine-containing foods. The primary exposure was the mean daily intake of creatine; the primary and secondary outcomes comprised lean mass excluding bone mineral content (BMC), and bone mineral density, BMC, lean mass including BMC, fat mass, and percent body fat, respectively. The average intake of creatine across the sample was 0.65 ± 0.72 g/day (95% CI, from 0.61 to 0.69). Creatine positively correlated with lean mass (excluding BMC) and BMC across the whole sample ( r = .18 and .20, respectively; P &lt; .001); a significant negative correlation was found between creatine intake and percent body fat ( r = −.09; P = .001). The higher intake of creatine was associated with higher lean mass in girls and higher BMC in boys, while taking more creatine corresponded to less body fat for both genders ( P &lt; .05). Our findings indicate a significant correlation between dietary creatine and DXA-derived body composition biomarkers in a nationally representative cohort of U.S. youth. These results justify further research of creatine’s role in modifying body morphology in the pediatric population, taking into account the age and sex specific traits.

Food Creatine and DXA-Derived Body Composition in Boys and Girls Aged 8 to 19 Years